Just two percent of the world’s population lives permanently at high altitude above 10,000 feet. These South Americans and Asians cope with altitude sickness either through their genetic evolution which, in the case of the Nepalese, took 6,000 years to develop enlarged lungs or something quicker— locally found herbs and other plant compounds to combat it.

For these farmers, miners, railroad workers, Diamox and other expensive Western meds are not an option. Instead a host of local brews that include coca leaf in Peru and Gingko Biloba along with other Chinese herbs have been used for hundreds of years.

The one common denominator with these indigenous solutions is they try improving blood circulation that allows the brain to tolerate low oxygen levels.

The big question for western trekkers is do any of them work? It’s a gray area as far as the U.S. medical establishment is concerned, but many trekkers are trying these alternatives with varying results.

Coca leaf high

Peru swears by its locally grown coca leaf and has been doing so for the last 5,000 years. In almost every hotel in Cusco coca leaf tea bags are available free for visiting trekkers to the city that sits over 10,000 feet. Many Peruvians you meet on the streets of Cuzco and Huaraz have a wad of these green leaves in the mouth and chew it throughout the day. Coca is the plant derivative of cocaine, but in leaf or tea bag form does not pack its psychoactive effect. Many travelers avoid coca fearing the narcotic side effects and coca is only legal in Peru, Bolivia and parts of Argentina.

Andrew Springsteel, Tusker’s South American guide has tried both coca leaf and tea and prefers the later. “I’m a fan of coca leaf tea, but I’m not into the leaf. I like the tea flavor and it has a mildly stimulating effect on me, but everyone is different”, Andrew said. “If you’re going to try the leaf I would vet the source and if you take it from someone’s hand it’s a risk (of infection). It’s important to realize that there is no silver bullet to treating altitude sickness, and Diamox has been clinically proven to help.”

China’s experiments

With China’s centuries old acceptance of herbs and other local medicines it’s not surprising it has used them to search for AMS solutions. The Chinese opened the world’s highest railway between China and Tibet in 2006 where a station in the Tanggula Pass sits at 16,640 feet, and studied 488 railway workers with AMS. They were given nine various herbal solutions in pill, powder and sterilized injection form and the six researchers concluded that these concoctions may have had a positive effect to reduce the severity of AMS. The Chinese are continuing to build new high altitude rail lines to Tibet and are likely to conduct more rigorous trials to see if Gingko Bilabo, Rodiolo, Fufang yi hao, or Sheng nao kang provide a cure for AMS. Stay tuned.

What should you take?

Tusker goes over 19,000 feet on Kilimanjaro and over 16,000 feet in Peru’s Cordillera Blanca as well as Nepal’s Everest Base Camp. Tusker founder Eddie Frank has canvassed the AMS remedies and recommends Diamox be your drug of choice to combat AMS. That decision is current with The Wilderness Medical Society’s assessment of the full range of global remedies to the problem.

“Although several trials have demonstrated a benefit of Ginkgo in AMS prevention, several negative trials have also been published. This discrepancy may result from differences in the source and composition of the Ginkgo products. Acetazolamide (Diamox) is considered a far superior prophylaxis for AMS prevention,” the society writes.

As for coca, the Wilderness Medical Society acknowledges it’s being used in the Andes, Asia and Africa, but cautions coca has not been systemically studied and should not be substituted for drugs like Diamox that have been studied.

It’s your climb and it’s your body so you make the call on how to prevent AMS. Many of Tusker’s climbers opt for the natural approach by going slow, hydrating, eating properly while being in peak physical condition for the trek. This organic approach sounds like the closest thing to AMS’ silver bullet so far.